Anticholinergic burden, oral hygiene practices, and oral hygiene status\u2014cross-sectional findings from the Northern Finland Birth Cohort 1966

Antti Tiisanoja,Pekka Ylöstalo,Vuokko Anttonen,Anna-Maija Syrjälä

doi:10.1007/s00784-020-03485-0

Antti Tiisanoja, Pekka Ylöstalo + Show 2 more

Open Access

https://doi.org/10.1007/s00784-020-03485-0

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Abstract

ObjectivesTo study the association between anticholinergic burden and oral hygiene practices and oral hygiene status among 46-year-old people.Materials and methodsThe study included 1945 participants from the Northern Finland Birth Cohort 1966 (NFBC1966), who had a complete dental status. The participants underwent clinical medical and dental examinations, and their medication data were gathered by combining self-reported drug use with information from the National Prescription Register. Anticholinergic burden was measured using nine previously published anticholinergic scales. Oral hygiene practices were assessed with toothbrushing frequency and oral hygiene status with the presence of visible dental plaque. Poisson regression with robust variance estimation and negative binomial regression models were used to estimate relative risks (RR).ResultsThirty percent of the participants reported brushing their teeth twice a day and about 25% of their teeth had dental plaque on them. Fifteen percent of the participants used at least one anticholinergic drug or had an anticholinergic burden according to the nine anticholinergic scales. After adjustments for confounding factors, the RRs of anticholinergic burden varied between 0.95 and 1.11 for toothbrushing frequency. Anticholinergic burden (according to Anticholinergic Activity Scale, Anticholinergic Cognitive Burden, Chew’s scale) was associated statistically significantly with the number of teeth with dental plaque. For the three scales, RRs varied from 1.24 to 1.50.ConclusionsAnticholinergic burden associated with poor oral hygiene.Clinical relevanceThe findings stress the importance of providing oral hygiene instructions and prophylactic measures to patients taking anticholinergic drugs.

Highlights

Good oral hygiene is a major preventive measure against common oral diseases, such as dental caries and periodontal diseases, and it is achieved by brushing teeth twice a day with toothpaste and cleaning the interdental region once a day [1]
The Northern Finland Birth Cohort 1966 (NFBC1966) originally included all children who were from the two northern provinces of Finland and whose expected date of birth was in the year 1966 (n = 12,231) [12]
Awritten consent for the study was given by all the participants and the study protocol was approved by the Ethical Committee of the Northern Ostrobothnia Hospital District (2/2012)

Summary

Introduction

Good oral hygiene is a major preventive measure against common oral diseases, such as dental caries and periodontal diseases, and it is achieved by brushing teeth twice a day with toothpaste and cleaning the interdental region once a day [1]. One medication group that could affect oral hygiene is drugs with anticholinergic properties This group includes several different drug classes with variation in their indications and anticholinergic potency, for example oxybutynin (urinary incontinence), quetiapine (antipsychotic), and citalopram (antidepressant) [9]. Cumulative exposure to these drugs and their overall anticholinergic effect can be measured with anticholinergic burden scales [9], which identify and score drugs with anticholinergic properties by combining expert opinions, literature reviews, and laboratory measures [9]

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